Traumatic Brain Injury

Traumatic Brain Injury (TBI) is damage to the brain from an external force — road accidents, falls, assault, sports. India has one of the world's highest TBI rates because of road-traffic injuries — the single biggest killer of Indian young men. Helmets and seat belts prevent a large share of severe TBI.

Severity

• Mild (concussion) — brief loss of consciousness or none, transient confusion, headache, nausea, memory gap.
• Moderate — longer loss of consciousness, more persistent symptoms.
• Severe — prolonged unconsciousness, focal neurological signs, potentially life-threatening.

Red flags — dial 112

• Any loss of consciousness after head injury.
• Worsening headache, repeated vomiting, seizures.
• Confusion, drowsiness, difficulty waking.
• Uneven pupils, weakness, numbness, slurred speech, double vision.
• Clear fluid or blood from ears/nose.
• Suspected neck injury — stabilise and don't move.
• Anticoagulants or bleeding disorder — lower threshold for evaluation.
• Children and older adults — lower threshold.

What to do at scene

• Dial 112; don't move a suspected neck/back injury unless essential for safety.
• Control bleeding with clean cloth without moving the head.
• Keep the airway clear; recovery position if unconscious and breathing, only if no spine injury.
• Apply gentle cold compress to any swelling.
• Note time of injury, events, medication list.

Evaluation and treatment

• CT scan — standard first imaging in significant head injury.
• Observation, monitoring of neurological status.
• Surgery — for bleeding in/around the brain, severe fractures, raised pressure.
• Intensive care for severe TBI.
• Rehabilitation — physiotherapy, occupational therapy, speech therapy, neuropsychology; long journey, major gains possible.

Post-concussion and longer-term

• Mild TBI: rest from cognitive strain and sport for several days, then gradual return.
• Concussion symptoms usually resolve within weeks; persistent symptoms ("post-concussion syndrome") deserve evaluation.
• Repeated concussions (sport, bike accidents) have cumulative effects — take them seriously.
• Long-term: risk of depression, anxiety, cognitive issues, post-traumatic epilepsy — structured follow-up helps.

Prevention — the highest-impact investment

• Helmet on every two-wheeler — reduces severe TBI death by ~40%. Legal requirement in India for riders and pillions.
• Seat belt every time, for every seat.
• Child car seats / child helmets.
• Don't drive drowsy, drunk, or texting.
• Fall prevention for older adults — home safety, vision, medicine review.
• Safe play, protective gear in contact sports.